Physicians have been taught to advocate for breastfeeding with our patients; however, our profession makes it challenging to practice what we preach.
Explore This IssueACEP Now: Vol 39 – No 02 – February 2020
The World Health Organization and American College of Obstetricians and Gynecologists (among many others) support breastfeeding exclusively for six months and continued breastfeeding for two years or more based on evidence showing benefits to mother and child.1–3 Some parents choose formula instead of breast milk for a variety of reasons, but in the United States, working mothers’ right to express (pump) breast milk for their infants is protected through amendments to the Fair Labor Standards Act.4 Nevertheless, returning to work correlates strongly with a decision to stop breastfeeding, particularly for those working in environments that are unsupportive.5,6
Our workplace, the hospital, is where many mothers learn to breastfeed. Supporting breastfeeding and pumping is a key strategy in recent efforts to make hospitals “baby-friendly.”3 For working physicians, resources and policies that encourage pumping on shift are critical. But that’s not where it ends. Our careers, especially in academia, do not exclusively take place within the hospital walls.
As part of career advancement and professional requirements, we attend professional conferences. We use testing centers to take standardized exams, including the United States Medical Licensing Examination (USMLE) and specialty board certification exams. Although “tips” exist for lactating women who want to pump at national conferences, systemic challenges remain.7 Similarly, social media backlash for the lack of lactation support at testing centers has made it clear that there is extensive room—and need—for improvement.8 When breastfeeding women are not supported to pump and/or breastfeed at conferences and testing centers, they are forced to choose between professional opportunities and their personal and family health. Like many women’s issues, this affects more people than is commonly appreciated: Women troubleshoot quietly or silently stay home, skipping conferences and thus losing out on networking and career development opportunities. Clearly, allowing for the physiological necessity of expressing breast milk in these overlooked venues is an issue of gender equity for our field.
Breastfeeding at Conferences: Mothers Without Infants On-Site
Basic requirements to allow women to pump at conferences are not extensive. Lactation spaces must:
- Provide spaces to sit with a power outlet within three to four feet.
- Be close to the conference hall and easy to get into with minimal (or no) help; requiring security to provide a key to a room is a burdensome step.
- Consider multiple pumping areas for large convention centers.
- Ensure privacy even with opening the door.
- Portable screens can create visual barriers as well as multiple private lactation stations within a larger room.
- Commercial options also exist for stand-alone stations (eg, Mamava).
- Offer nearby running hot water and soap for handwashing and cleaning pumping parts.
- Have cold storage space to store expressed milk during the conference day and either bagged ice or freezer space to protect ice packs for travel.
In addition to these basic accommodations, if feasible, it’s also helpful to provide: